National Provider Identifier [NPI]: |
1710968995 |
Last Name Of The Provider |
RICE |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
DMD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
90 BEAVER DR |
Street Address 2 Of The Provider |
SUITE 101A |
City Of The Provider |
DU BOIS |
Zip Code Of The Provider |
158012440 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Maxillofacial Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
110 |
Number Of Services |
1108 |
Number Of Medicare Beneficiaries |
394 |
Total Submitted Charge Amount |
288315 |
Total Medicare Allowed Amount |
161471.4 |
Total Medicare Payment Amount |
121374.18 |
Total Medicare Standardized Payment Amount |
123828.72 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
217 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
326 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2418 |